Học bổng JDS 2016

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Trung tarn Hop tic Qu6c t6 Nhat Bin tai Viet Nam (JICE), Ting 3, T6a nha Vi?t -NTEL04.3934.77„FAx04.3934.77]Owebhttp;yjds-schoing6.01AITQTNB
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Thong tin v6 Chum.ng trinh Hgc bang Phat tri6n ngu6n Nhan lT'c
do Chinh phfl Nhat Ban tai trq JDS 2016
Trung tarn Hay tac Qu6c t6 Nhat Bin (JICE) xin gtii ldi chao tram trQng t6i Qdy co. quan.
JICE tri6n khai du an HQc b6ng Phat tri6n ngu6n Nhan luc Nhat Ban (JDS) do Chfnh phd
Nhat Bin vi?n trQ Oho Viet Nam. HQc b6ng JDS la hQc b6ng Thac s? toil phan 2 nam tai
cac tuning DH cda Nhat Ban (Chuo'ng trinh giang day bang ti6ng Anh). Hoc b6ng
JDS huchg den 6ac d6i tuqug la can b©, c6ng chtrc, vien chtrc, giang vien tai cac co quan
nha nu6c va cac truing DH CD c6ng lap d Vi?t Nam.
Thay mat Ban Chi dao Du in, JICE kinh d6 nghi Qdy co quan h6 trQ quang ba thong tin
v6 chuong trinh hQc b6ng JDS 2016 hhu sau:
1. Tri6n khai c6ng vin,v6 tuy6n sinh hQc b6ng JDS den toil b§ cia b©, c6ng chd.c, vien
chic, giang vien (neu c6) ctia Qtry co quan va cac dcm vi trtrc thu©c.
2. Treo, din ap phich va t6 roi v6 hoc bang JDS tai m¢t s6 di6m trong co quan nhu 16i
ra vao va sanh chinh.
3. Tao di6u ki?n d6 trng vien nap h6 so du tuy6n hoc bang JDS 2016 va tham dp cac
v6ng tuy6n sinh tai Ha N§i.
4. Cho ph6p ling vien tap nghi c6ng tac d6 tham gia cac hoat d¢ng cda chuong trinh n6u
tug vien duQc nhan hQc b6ng.
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Ching t6i xin gdi kem theo thu nay cac tai li?u sau day:
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Th6ngtin chiti6tv6hQcb6ngJDS 2016
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•
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Cinnang ho6ng dan n©p h6 sohQcb6ng
B¢h6sohocb6ng
?
Ap phichvat6roi cdahQc b6ngJDS 2016
Sp hop tic ctia Qdy co quan trong viec tri6n khai thong tin v6 hQc b6ng JDS s€ g6p phil
quan trQng vao su thanh c6ng cda chuong trinh nay.
Moi thong tin chi ti6t, vui long li6n h?:
Trung tarn Hen tac Qu6c t6 Nhat Ban (JICE)
Van ph6ng Dqu an hgc bang JDS tai Vi?t Nan
TAng 3, t6a nha Vi?t-Nhat, 91 Chda Lang, D6ng Da, in N©i
DT: 04-39347711
Email: ds.vietnam
Trung tan Hay tac Qu6c te Nhat Ban
Via ph6ng Du an hQc b6ng JDS tai Vi?t Nam
EICE
¥'...I.. =`.i -... I.-.I-,I..i,..=i
,'ti
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Trung tarn Hay tfro Qu6c te Nhat Bin tai Viet Nam (JICE), Tang 3, T6a nha Viet -Nhat (VJCC), 91 Chtia Ling, D6ng Da, Ha N©i
TEL 04-3934-7711
FAX 04-3934-7710
Web: http://jds-scholarship.org/country/vietnam/
CHUONG TRiNH HOC B0NG PHAT TRIEN NGUON NHAN LUC NHAT BAN
(JDS) 2016
1. Gidi thi?u chung
HQc b6ng Phat tri6n Ngu6n nhin luc Nhat Ban (JDS) 1a chuong trinh hoe b6ng toil phil
do chinh phi Nhat Ban vi?n trQ kh6ng hoan lai cho Vi?t Nam. Muc tieu ctla JDS la h6 trg
phat tri6n ngu6n nhan luc cda Viet Nam, d6ng th6i m6 rang va that chat quan hS song
phuong Vi?t Nam - Nhat Ban thong qua vi?c cap hgc bang kh6a hgc Thac sy trong hai
nam bang ti6ng Anh tai cfc tru.ing Dai hoc cda Nhat Ban. D6i tuqug cda JDS la cde can
b¢, c6ng chtrc, vien chtrc, giing vien hi?n clang lam vi?c tai cac co quan nha nu6c, truchg
Dai hQc, Cao ding c6ng lap - nhthg ngudi dugc ky vQng s5 than gia tich cuc vao viec
hoach dinh, thuc thi chinh sach phat tri6n kinh t6 - xa h¢i ctia Viet Nam sau khi hoin thinh
kh6a hoc.
2. Thong tin chung v6 nganh, truing, bang cap va chi ti6u
Truing D?i hgc
Nganh hgc
1 - 1 . Ting cuchgHeth6ngkinht6thitruing
Dai hoc Hitotsubashi
Thap sy Chinh sach c6ng(Kinht6c6ng)
Chiti6u
3
(IUJ)
Thac sy Quin tri Kinh
doanh
2
Dai hoc Hiroshima
Thac sy Ky thuat
2
Dai hQc Qu6c t6 Nhat Ban
1 -2. Phat tri6nmanglu6iGiaothongvftytaivaPhattri6nd6thi
Bang cap
Thac sy Khoa hQc M6itruchgThacsyKythuat
Dai hQc Nagoya
1-3. Ngu6nningluqug6ndind
2-1. N6ng nghi?pvaPhattri6nN6ngthen
2
(IUJ)
Thac sy Phal tri6n Qu6c t6
Thap sy Kinh t6
2
Dai hoc Kyushu
Thap sy Ky thuat
2
Dai hoc Kyushu
Thap sy N6ng nghi?p
3
Thac sy N6ng nghi?p
2
Dai hQc Qu6c t6 Nhat Ban
Dai hoc N6ng nghi?p vaC6ngngheTokyo(TUAT)
2-2. M6i truchg,Bi6nd6ikhihau,
Ngin ngtra thinhoa
3-1 . Ting cuch8 heth6ngluatphap
Dai hoe Tsukuba
Thac sy Khoa hoc M6i
truchg
4
Dai hoc Nagoya
Thac sy Luat
2
Dai hoc Kyushu
Thac sy Luat
2
Thac sy Quin tri c6ng
2
Thac sy Chinh sach c6ng
2
Dai hoc Qu6c t6 Nhat Bin(IUJ)
3-2. Tang cuchgminglpchanhchinh
Dai hQc Meiji
Tang c¢ng
30
EICE
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Trung lam Hap tac Qu6c t6 Nhat Ban tai Viet Nam (JICE), Tang 3, T6a nha Viet -Nhat (VJCC), 91 Chtia Lang, D6ng Da, Ha N©i
TEL 04-3934-771 I
FAX 04-3934-7710
Web: http://jds-scholarship.org/country/vietnam/
3. Di6u ki?n dqu tuy6n
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La c6ng din vietNam, cutrd d vietNam tai thai di6m n©p h6 so
La c6ng chtrc, vien chtrc lam vi?c tai cac co quan va dcm vi trtrc thu©c nha nu6c
•
Tu6ittr24-39 (tinhd6no1/04/2017)
•
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C6 it nhal 02 nam kinh nghi?in c6ng tac toil thai gian tai co quan nha nu6c (`trong d6
bao g6m it nhal 06 thang lil viec tai co quan hien tai) tinh t6i thai di6m nap h6 so
T6t nghiep dai hQc (chfnh quy) tai cac truchg dai hQc tai vi?t Nan hoac nu6c ngoal
Chua tthg dupc nhan bat ky hQc b6ng nu6c ngoai nao d trinh d¢ thac si.
Nhting ngu6i clang therc hi?n/clang trong danh sach ch6 thuc hien nghia vu quan su
kh6ng dugc du tuy6n hQc b6ng JDS.
Trinh d¢ ti6ng Anh: t6i thi6u TOEFL ITP 500 (tuong duong CBT 173, iBT 61,) hoac
IELTS 5.5 (kh6ng c6 ky ming nao du6i 5.0). N6u chua c6 chthg chi vao th6i diem nap
h6 so, ling vien se dugc tham gia ky thi TOEFL ITP mien phi do via ph6ng JICE t6
chtrc).
4. L!ch bi6u tuy6n chon du. ki6n
Gitra thang 11, 2016: Sau ki6m tra h6 so, cac ling vi€n thi TOEFL
Ki6m tra
ti6ng Anh /Toin
(ITP) va Toin tai in N§i, Da Ning va TP. H6 Chi minb. Ung vien n¢p
h6 so ngalih Lust cac truchg Dai hoc Nagoya va Kyushu kh6ng phai du
thi Toil.
V6ng 1
V6n8 2
V6ng 3
Thfng 12, 2016: Giho su cac truchg dai hQc Nhat Ban x6t duy?t h6 so.
Thang 1/2, 2017: Giao su Nhat Bin ph6ng via chuyen m6n tai Ha N©i.
Thing 3, 2017: Thach vien Ban Di6u hanh Choong trinh doc bang JDS
phong via chung a Ha N©i.
5. Quy trinh n©p h6 so.
Ung vi€n truy cap trang web httD://ids-scholarship.org, ding ky thong tin ca nhin va nhch
mat khau ttr chuong trinh JDS d6 tai tai lieu Huchg dan tuy6n sinh va b§ H6 so hQc bang.
D6 nghi n¢p h6 so giiv truc ti6p hoac qua bun dien den vin ph6ng JDS.
6. Ham n§p h6 sol: 17:00 ngav 21/10/2016 IThtr Sfu 1
7;)ChT6r:#qgfbfifuy6nsinhdvi?tNan
•
•
Mi6nphi thi TOEFL ITP vaki6m tra stlc kh6e do JICE t6 chic.
H6 try phi di lad va luu trd`cho cde v6ng load (chi dinh cho cac ling vi6n khu vtrc ngoal
•
mNoi)vakh6ahpedinhhu6ngtaimN©i(chotalca\ingvientr`ingtuy6n).
Mi6nphixinvisa
b) Sau khi tring tuy6n
• HQc phi tat cac co sd giao duo sau dal hocNhat Ban
•
•
V6mdybaykhih6i vi?tNam <iNhatBan
Sinh hoatphi hang thing tai Nhat Bin
•
•
•
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TrQ cap ban din c6 dinh d6 mua may tinh, hQc lieu
H6 trgti.in nha d va mi6nphi ti6n dat coc nha6tai Nhat
Chi phi tham du h©i thao trong nu6cNhatva qu6c t6
Chi phi van chuy6n d6 dac ve vi?tNan sau khi hoc xong
Bao hi6m y t6 trong thdi gian 6Nhat Bin
®ifelk,I
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Trung tan Hay tac Qu6c t6 Nhat Ban tai Vlet Nam (JICE), Tang 3, T6a nha Viet -Nhat (VJCC), 91 Chba Ling, D6ng Da, in N©i
TEL 04-3934-77l I
FAX 04-3934-7710
Web: http://jds-scholarship.org/country/vietnam/
8. L!ch h©i thao gidi thi?u hgc bang JDS 2016
On glan
!a
lem
15:00 -17:0012/08/2016(Thti 6)
Ha N6i
9:30 - 11 :3027/08/2016(Thtr 7)
9:30 -12:00og/o8/2oI6(Thtr 3)
Tang 3 , T6a nha Viet-Nhat (VJCC), Tru6mg
DH Ngoai thuong, 91 Chda Ling, D6ng Da,
Ha N6i
Truchg DH N6ng Lam Tp. H6 Chi Minh
Khu ph6 6, phuing Linh Trung, quan Thti
Dtrc, TP. H6 Chi Minh
TP. H6 Chi Minh
13:30 ~ 15:30
og/o8/2oi6 (Thtr 3)
14:00 -17:0010/08/2016(Thtr 4)
cia Tho
S6 N¢i vu Thinh ph6 H6 Chi Minh, 868 Le
Thanh T6n, Quan 1 , TP. H6 Chi Minh
Turchg Dai hoc Cia Tho, Khu 11, Duchg 3/2,
phuchg xuin REinh, Ninh Ki6u, Tp. cia Tho
Da Ning
15:00 -17:00
23/o8/2oi 6 (Thtr 3)
TT Hinh chinh TP. Da Ning, 24 Trio Phi,
Phuchg Thach Thang, Quin Hai Chau, TP. Da
Ning
15:00 -17:0024/08/2016(The 4)
Hue
H¢i truchg Dai hQc Hue, s6 3 Le Lgi, TP. Hue
Vui long truy cap trang web httD://ids-scholarship.org d6 bi6t thong tin chi ti6t.
9. Li6nh6:
Trung tin Hay tac Qu6c t6 Nhat Bin (JICE)
Vin ph6ng Du in JDS tai Viet Nam
Ting 3, t6a nha VJCC, 91 Chha Ling, D6ng Da, in N¢i, Vi?t Nam
Tel: (04) 39347711/12
Email: [email protected]
The Project for Human Resource Development Scholarship by Japanese Grant Aid (JDS)
in Vietnam 2016
Application Checklist
Date of Submission:
Full Name:
Component:
University:
No.
Remarks
Required Documents
Application Checklist(Thisform)
1
Check if all the necessary documents are ready.
•
2
Application Form(Prescribedform)
•
3
University
•
Degree/Diploma
•
4
Official Academic
•
Transcript
Reference Letter"Annex„(Prescribedform)
5
Tick
Attach yourphototaken within the last3 months (3x4 cm)
to each Application Form.
Sign EACH PAGE on the lower right-hand corner.
lf in Vietnamese language: Submit notarized English
translation.
lfin English language: Submit notarized copies
Transcript must contain all the grades earned in the
university
•
Filled-in by the current employer or supervisor.
•
•
Must be sealed in an envelope upon submission.
Written in English or accompanied with a notarized
English translation if in Vietnamese.
International English
6
proficiency test result,
•
•
31, 2017.
(lELTS or TOEFL)
passport QIlDcard
Optional: Onlyforthose who have a qualified score.
Testresults mustbe no morethan 2yearsold asofMay
•
For passport: Photocopy of the personal page only.
•
For lD card: Submita notarized English translation.
•
Signed and sealed by the authorized representative of the
7
8
Official NominationLetter(Prescribedform)
current organization .
•
9
Proof of EmploymentHistory
Only an official nomination letter in vietnamese is needed.
Submit a notarized English translation of labor contract(s) or
decision of employment showing qualified work experience to
JDS requirement.
10
Questionnaire A(Prescribedform)
Questionnaire 8(Prescribedform)
11
•
•
•
Medical History and Present Health Condition
Source of Information
please submit 3 full sets ofaDDlication ll original and 2 photocopies}.
Do notstaplethedocuments butcljpon them.
Use only one-sided A4-sized paper and arrange all application sets in the above listed order.
* Please sign all the pages on the lower right-hand corner
The Project for Human Resource Development Scholarship by Japanese Grant Aid (JDS)
in Vietnam 2016
APPLICATION FORM
------------------------------------------------------------------------------------------------------------------------..-.------....
1.
Studycourse
• Please select the Component and accepting university of your choice by ticking the corresponding box. (One tick only)
Sublprogram
Component
Accepting universities course
Hitotsubashi University
1-1 Strengthening of MarketEconomySystem
School of International and Public Policy
International University of Japan
Graduate School of International Management
1. Promotion of Economic
Growth and Strengthening
of International
Competitiveness
1 -2 Net\^/ork Development for
Transportation and
Communications,
Urban Development
Hiroshima University
Graduate School for International Development and Cooperation
Nagoya University
Graduate School of Environmental Studies
International University of Japan
Graduate School of International Relations
1-3 Stable Supplies for Energy
Kyushu University
Graduate School of Engineering
Kyushu University
Graduate School of Bioresource and Bioenvironmental Sciences
2-1 Agriculture and RuralDevelopment
2. Countermeasure against
Tokyo University of Agriculture and Technology
Vulnerabilities
Graduate School of Agriculture
2-2 Environment, climate
Change, Disaster Prevention
University of Tsukuba
Graduate School of Life and Environmental Sciences
Nagoya University
3-1 Strengthening of the LegalSystem
Graduate School of Law
Kyushu University
Graduate School of Law
3. Strengthening ofGovernance
International University of Japan
3-2 Strengthening of theAdministrativeCapacity
Graduate School of International Relations
Meiji University
Graduate School of Governance Studies
2.
Applicant personal Information (1)
* Details given in this section must match your passport or other official identification documents
1 ) Full name
Attach your recent
(as written in
photograph here
(Should be takenwithin3months)Pleasewriteyournameonthebackofthephoto(3cmx4cm)
passport or lD card)
2) Date of Birth
4) Gender
YYYY/ MM / DD
I Ma,e
I Female
3) Age
5) MaritalStatus
_
(asoflstApril2017)
I sing,e I Married
Tick
I
I
I
I
I
I
I
I
I
I
I
I
I
* Please sign all the pages on the lower right-hand corner
4.
Educational Background
(1) List all schools attended starting from primary school (in chronological order).
I Graduation date and names of degree given in this section must match your submitted diplomas / certificates.
I Do not list short-term training courses.
I Please count as one year if school year starts in September and ends in June.
• lf you did not complete a school, mark `incomplete'. If still in school, mark "in school".
Level
(Ex.)
Name of SchoolDepartment
XXX University
Faculty of XXX
Location
Hanoi
From ITo(Monthrvear)
09/1999
06/2003
//
PrimaryEducation
SchoolingPeriod
Degree
4 Years
Bachelor of
XXX
Years
LOwerSecondaryEducation
//
UpperSecondaryEducation
//
Higher
Education(University level)OtherHigher
/
Years
/
Months
/
Years
/
Months
/
Years
/
Months
Education(excepttraining)OtherHigher
Education(excepttraining)
Total School Year:
Years
Years
_year(s) _ month(s)
* Please sign all the pages on the lower right-hand corner
(2) Scholarship applications record
1 ) Have you ever been awarded any scholarship studying abroad?
I Yes -Name of scholarship:
I No
Country you studied in:
Duration (month/year):
_/
-(month /year) _/_
Obtained Degree:
2) Are you currently applying for another scholarship programs?
I Yes -Name of scholarship:
I No
3) Have you ever applied for JDS Project before?
I Yes -Study field, university, year you applied: (Ex.) F/.e/d of Law . Ivaoova Un/.vers/.fv . 2074
(List all, if more than one.)
5.
,
_,ENo
,
Work Experience
(1) Work Experience (as of application)
• List your work experience from the most recent full-time work. Attach another sheet if necessary.
• DO NOT include part-time job, internship, volunteer activities, or full-time job before graduation from university as your
work experience.
Department/
Organization / Company
Division
XXX Division,
(Ex.) Ministry of XXX
***Department
Position Title
From /To
Period of
(Monthrvear)
Employment
08 / 201110/2016(Current)
Deputy Director
//(Current)
Total Period of Work Experience:
C. Research Institution/center (State) ,
yearsmonths
//
yearsmonths
//
yearsmonths
_ year(s) _ month(s)
(2) Your current occupation
Position Title
Division, Department
Organization ( in English)
( in Vietnamese)
Address
Mother body of your organization(ifany)
B. State corp./ State co.
D. Educational institution (State),
yearsmonths
//
*For the type of organization above, choose the applicable alphabet below:
A. Ministry/Governmental agency (Central or provincial)
5 years
3 months
E. Others (Please specify)
*Type
A
Select
Select
Select
Select
* Please sign all the pages on the lower rightThand comer
6.
Describe your responsibilities ofyourwork
Please give a detailed description of your (1) Current Work and (2) Previous Work, including nature of work,
major responsibilities, employees under your supervision, size of budget, and results achieved. IMaximum 1
(one) iraael
* Please sign all the pages on the lower right-hand corner
7.
Research proposal
Write a brief research proposal of your Master thesis within 3 (three) pages of A4 sized paper with
no more than 700 words, and attach to this Application Form.
Q7
Important Notes:
/ The research DroDosal must be tvDed and cleariv indicated
Researdiptord
R-title
as "Question 7: Research Proposal". "researoh title". Put
vour name and sianature in each Daae. and insert it under
this page.
Name / Signature
/ Compose your research proposal having such points as a theme, approaches, methods, contribution to
the development, etc. For further details, refer to "Guideline for Writing a Research Proposal" and
"Warning about Plagiarism"' (page 10-11 ) of the Application Guidelines (AG).
/ Strongly recommended to write your research proposal having connections with the following points.
• Sub-Program / Component (Check theAG)
• University curriculums and research areas of faculty members
• Your work, duties and future career plans
(Check the AG, Univ website, etc)
Note: ONLY Applicants applying for Nagoya University (Component 1-2 : Network Development for
Transportation and Communicatio ns, Urban Development) have to fill this.
I Write a name(sl of Professor(sl under whom vou want to studv.
/ Go to the link httD://ids-schola rshiD ora/countrv/vietnam/univ naaova env html to check research
areas of professors. and choose at least 1 (one) preferred professor and indicate it below.
/ Remember that Nagoya Univ ersity shall assign your academic advisor based on your research topic.
This serves for reference purpose only, and will not affect the selection.
Academic advisor (s) on your choice
1.
8.
2.
3.
Considering the Sub-Program/Component of JDS Project which you have selected, how
would you utilize the knowledge, skills and experiences that you gained in Japan to
contribute to the development of Vlel:nan?
/ Your answer must be typed in 400-500 words rMaxjmum 2 (twol Daaesl
/ Use separate sheets of A4 sized DaDer. cleariv indicate as "Question 8" and insert it under your
research DroDosal above.
/ Do not forget 1:o put your signature on each page of the attachments
* Please sign all the pages on the lower right-hand corner
9.
Declaration
I, (print your full name)
declare that I apply for JDS Project with full understanding "Application Guidelines",
especially the articles stipulated below:
1.
All the information that I provided in this Application Form by me are true and
accurate to the best of my knowledge and ability. My application may be
cancelled if any information mentioned above is found to be false.
2.
Ifthe Application Form is incomplete orwith missing necessary documents, it is
regarded ineligible.
3.
All the selection process and the decision are entirely entrusted to the
secretariat of JDS and any inquiries or objections by applicants regarding the
result of the selection shall not be permitted.
4.
If any act of dishonesty is found other than those above in the application and
selection process, I shall not lodge any complaint about cancellation of the
application resulting from such act.
5.
The objective of the JDs is to provide vietnamese Government employees with
opportunity to study in Japan at master's level in order to support national
efforts to achieve social and economic development in Vietnam. Thus, the JDS
fellow is under the obligation to complete the course program within the
prescribed period of study; and then return to the country, contribute to the
development of Vietnam and remain in Vietnam at least for two years after
completing master's degree in Japan.
6.
I agree that my personal information in the Application Form, provided to Japan
International Cooperation Center (JICE), shall be used exclusively for the
purpose of the operation of JDS Project.
Signature:
(*Please sign at the bottom of all the pages including this page)
Date : (day)_/(month )_/(year)
For 1:he Employer/ Supervisor
Annex
The Project for Human Resource Development Scholarship by Japanese Grant Ald (JDS)
ln Vletnam 2016
REFERENCE LE-ITER
This reference letter is to be completed by the current employer/ supervisor from the applicant's work Place.
This should be typed clearly in English and put in a sealed enveloDe.
Full Name of the Applicant:
To the referee: This is an integral part of an application form for the scholarship program provided by the Ministry of Education and
Training of the Socialist Republic of Vietnam under the Grant Aid Program by the Government of Japan. This particular
program offers opportunities for academic research at Japanese higher educational institutions. Also, this is to enhance
the leadership skills of young government employees in Vietnam so that they can contribute more effectively to their home
country after completion of their respective studies. Your candid responses to the items below would greatly assist the
selection. Please return the form in the sealed envelope to the applicant.
1. How long have you known the applicant and in what context?
2. How do you estimate the applicant's personality?
(Strength)
3. How do you describe the applicant's competence and weakness in his/her work?
(Competence)
4. How do you appraise the applicant's ability that he/she will fill upon his/her return to Vietnam, and the duties
he/ she will undertake?
Annex
5. Please evaluate the applicant regarding the following items in comparison with other staff: please tick (v')
one each.
Excellent
Good
Average
Below Average
Academic Ability
Knowledge of Specialty Field
Motivation & Diligence
Potential for Future Contribution in Specialty FieldLeadership
Emotional Maturity
Communication Skill
Skill in Maintaining Personal Relationship with othersAdaptabilitytoNewEnvironment
6. Other recommendation remarks:
7. Relevance of the applicant's research plan and his/her current work; (please tick (E]) one from below)
I Strongly relevant / I somewhat relevant / I not relevant
Comments:
Full Name of the Referee:
Relationship to the Applicant:
Name of Organization/ Department/ Division:
Title:
Phone No.:
Fax No.:
E-mail:
Signature:
Date : (dav)
/(month)
/(Year)
ChuJong trinh Hoe b6ng Phat tri6n Ngu6n nhan lquc Nhat Ban (JDS)
tai Vjet Nan 2016 *
Thor Gi67i thieu
Thu nay xac nhan dJng vjen duJ6Ji day hien la ..... (c6ng chdJc/vien chdJc, gjang vjen/ .... )
cda ...... (ten co quan, t6 chdrc) va duJ9Jc ph6p tham gia dqu tuy6n Hpc bang JDS 2016.
Xac nhan tren la dtlng SUJ that va nam trong khu6n kh6 quy6n ham cda chtlng t6i.
±±ng+±i6n du6Jc ai6Jj thieu ducyc p_±dr
1.
tarn nghi viec 6 co quan d6 tham gia kh6a hQc d!nh hu¢ng tai Ha Noi truJ6c khi di du hQc.
2.
tarn ngh? viec a co quan d6 tham gia hoc tap chuong trinh Thac sT 2 nam tai trudng E)ai
hoe tai Nhat Ban v6i tar cach la nghien cdru sinh thu©c Chuong trinh HQc b6ng Phat tri6n
Ngu6n nhan luJc cda Chi'nh phd Nhat Ban (JDS).
3.
quay v6 lam viec tai don vi hien clang c6ng tic sau khi hoan thanh kh6a hoc.
HQ va ten trng vien:
Ccy quan va
CO quan:
ph6ng/ban:^,1
Ph6ng/ban:
Xac nhan boll:
Ten cda nguJdyi daidien:
Vi tri/Chdrc danh:
Ph6ng/ban:
CO quan
ChoJ ky cda ngurdidaidien
Dau cda co quan:
Ngay/thang/nam
*vuil6nginThurgidithieunaybanggi6yc6tieudecdaccyqua:ri:JTi€:i:I::i)
Questionnaire A on Medical History and Present Health Condition
e eligible for JDS, applicants must be in good condition physically and mentally since the time of
cation to the time of return to the Vietnam after completion of his/her course in Japan. During the period
_ _ _ -
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of scholarship
awarded, JDS fellow
must dedicate himself/herself to the study program of the university
he/she attends. Therefore, in case there is a drastic change in fellow's health condition before his/her
departure to Japan, and if university considers his/her condition not suitable enough in the pursuit of
academic goal, scholarship is subject to cancel, based on the decision/guidance of university and the
Operating Committee of the JDS Project.
i . unecK
..yes" or "No" to each item listed below and explain
k"Y„
the condition if "Yes".Yes+Describethe detail d
Question
e
d.t.
con lion
Have you had any significant or serious illness or injury?
lNol
(lf hospitalised, give place & dates)Haveyouhadanyoperationsoradvice by a Physician to have an
operation? (Place & dates)Doyoucurrentlyuseany medicines for treatment of a medical
condition? (Give name & dose)Haveyoueverbeenapatientin a mental Hospital or sanatorium
or treated by a Psychiatrist? (place & dates)
2.Pleasecheck"Yes"or"No"toeachitemlistedbelowandenclosetherelevantconditionwithacircleif"Yes".
Do you currently have or have you ever had the conditions as follows? (lf it has already cured,
please
"C"' in th
--±'
tne column of "Yes" instead of circling)
Condition
Asthma, emphysema, or other lung conditions (specify:
YesN 0
)ITuberculosisorlivewithanyonewhohastuberculoslsHighbloodpressure,heartdisease
Stomach, liver (hepatitis), gall bladder disease
Kidney or bladder disease, stone or blood in the urineDiabetes(sugarintheurine)
Acquired Immune Deficiency syndrome (AIDS)
|Depression,excessworry,sleepdisorderorotherpsychologicalsymptomsI
|Tumour,abnormalgrow,cyst,orcancerI
BIeeding disorder, blood disease (sickle cell anemia)
3. Describe your present health condition in detail
1certifythat1havereadtheaboveinstructionsandansweredallthequestionstruthfullyandcomp[etelytothe
best of my knowledge. I will inform JICE immediately in case there is any drastic change in my health
condition during the following selection process and before my departure to Japan.
Signature:
Questionnaire a on Source of Information
Please select EE the most appropriate answer(s) and describe your idea. This questionnaire will be
used only for improving JDS Proj.ect in the future, and has no influence on selection results.
Name:
1.
How did you E!B§| get to know JDS? (Select one only)
I JDS Fellows/Alumni
I Belonging Organization
I VIED
I Embassy of Japan
I JICA
E Poster/Flyer,
I JDS Fanpage "Hoc b6ng toan phan Chi'nh phd Nhat Ban JDS"
I Newspaper/internet news site
I Other (please specify:
2.
Did you see the following promotion tools? (Multiple answers allowed.)
I Poster
I Flyer
I Application Guidelines
I JDS Website
I JDS Fanpage "Hoc bang toan phan Chi'nh phd Nhat Ban JDS"
I Articles on newspaper (please specify the newspaper:
I Announcement on VIED website
I Web Video about JDS
3.
Did you attend the JDs information session?
I Yes (place:
4.
)HNo
Why did you choose JDS from among foreign scholarship programs? (Multiple answers
allowed)
I Program design (field of study and accepting university)
I Fairness and transparency of selection
I Fulfilling financial support (full-scholarship and various allowances for two year study in Japan)
I Allowance to take part in the selection (transportation allowance, free TOEFL test)
I Reputation of JDS
I Recommendation from JDS Fellows/Alumni
I Networking opportunity with other JDS fellows/alumni during/after study in Japan
I JDS enrichment programs during study in Japan (orientation, seminar, field trip, etc.)
I Well-developed supporting system (monitoring support and advise from JICE)
I Other (please specify:
Any comment or recommendation to improve the JDS promotion activity
Thank you for your cooperation.